| NPI | 1326396938 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA 002796) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 8092T) |
| Enumeration Date | 2012-08-29 |
| Last Update Date | 2021-09-24 |